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There is excuse-making and then there is an entire damned industry that works its level best to asset-strip you to your underwear so your fat ass (and the rest) hangs out.
“The key point is that you can be on TV, you can lose enormous amounts of weight, you can go on for six years, but you can’t get away from a basic biological reality,” said Dr. Schwartz, who was not involved in the study. “As long as you are below your initial weight, your body is going to try to get you back.”
Well sure, if your "path" to weight loss is to eat damn near nothing (e.g. starve) and run your metabolic demand through the ceiling by engaging in extremely intense exercise.
Look at the quotes: "It's hard. The cravings are there."
But the kernel of truth is right here:
“There is a lot of basic research we still need to do,” said Dr. Margaret Jackson, who is directing a project at Pfizer. Her group is testing a drug that, in animals at least, acts like leptin, a hormone that controls hunger. With weight loss, leptin levels fall and people become hungry. The idea is to trick the brains of people who have lost weight so they do not become ravenous for lack of leptin.
Pfizer wants to sell you a drug, of course.
But what if you learned that hunger is largely regulated by leptin, leptin response is largely mediated by insulin levels, and it is what you eat, not how much, that is almost-entirely responsible for insulin levels?
Guess what: That all happens to be true.
What is being discussed here is that the contestants on the show The Biggest Loser basically poisoned their metabolism through the path they engaged in -- that is, extreme caloric restriction coupled with intense exercise.
But the "big lie" is right here:
“What was surprising was what a coordinated effect it is,” Dr. Proietto said. “The body puts multiple mechanisms in place to get you back to your weight. The only way to maintain weight loss is to be hungry all the time. We desperately need agents that will suppress hunger and that are safe with long-term use.”
Agents, of course, means drugs. Yeah that's a great idea -- hand over $10,000 a year forever to someone for a pill that will probably have side effects that destroy your life (eventually.)
Look at what they had these people eat:
His routine went like this: Wake up at 5 a.m. and run on a treadmill for 45 minutes. Have breakfast — typically one egg and two egg whites, half a grapefruit and a piece of sprouted grain toast. Run on the treadmill for another 45 minutes. Rest for 40 minutes; bike ride nine miles to a gym. Work out for two and a half hours. Shower, ride home, eat lunch — typically a grilled skinless chicken breast, a cup of broccoli and 10 spears of asparagus. Rest for an hour. Drive to the gym for another round of exercise.
Mother of God will you stop killing yourself?
Look folks, fat in the diet is not fat on the body. This sort of "diet" is nothing other than starvation and it's stupid.
What's the problem? Right here:
His slow metabolism is part of the problem, and so are his food cravings. He opens a bag of chips, thinking he will have just a few. “I’d eat five bites. Then I’d black out and eat the whole bag of chips and say, ‘What did I do?’”
Get the damned chips out the house!
Oh, and the rest of the carbs.
You're not sick because you're fat (and cut the "shaming" crap, facts just are) you're fat because you're sick and you're sick because you refuse to stop eating things that make you that way.
Look folks, I know you don't want to hear it because you're all looking for a drug and an excuse.
That's why you lose 10, 20 or 30lbs, then put it all back on with interest.
You can't stop eating pasta, potato chips, pizzas and bread.... Really? You're willing to trade being fat and ultimately developing diabetes causing you to have your toes chopped off one by one as they turn gangrenous, along with losing your eyesight and ultimately your life, rather than getting the damned potato chips out of your house and not calling Papa Johns or Dominos? REALLY?
You do understand that your body's metabolic system is capable of handling quite the level of insult before it breaks, right? That you "pass" the common glucose test (OGTT) or have a normal (or marginal) A1c today does not mean you have not accumulated decades of such damage and that while there is a test to determine this (OGTT+insulin assay) it's expensive and insurance will not pay for it since it doesn't diagnose a disease that is occurring now.
You do understand that the majority of adults in America and damn near everyone over the age of 60 are metabolically compromised by decades of eating fast carbohydrates and vegetable oils, even if you do not today show evidence of diabetes and related diseases, and that if you are overweight, even only somewhat, or obese it is a virtual certainty you're one of them irrespective of age, right?
I've been there and done this over the space of a couple of decades. I too poisoned myself because I was ignorant and believed that if I ate fewer animal fats, more vegetable oils and more carbohydrates while simply exercising more and eating less I'd lose weight and keep it off -- along with avoiding said disease.
Everyone who told you this either didn't know what the hell they were talking about or was lying. The results were the same as they are for most of you -- slowly but inexorably increasing body weight.
Then I changed what, not how much, I ate and my body's regulatory system healed over time. Is it completely healed? I'm sure it's not, and if I was to go back to eating how I used to eat all the weight I lost and probably more would come right back on -- and quite quickly too.
But guess what? You can do it too. I don't care how fat you are now or how long you've been fat. I don't care if you've yo-yo dieted before, or engaged in some sort of extreme attempt to lose weight.
You're overweight because you have poisoned the regulatory systems in your body that control your desire to eat. You almost-certainly poisoned them unintentionally but whether it was intentional or not does not matter; what matters is that it happened and unless you change what you eat the damage will continue to accrue over time and at some point it is very likely it will manifest itself as clinically-diagnosed disease.
To succeed in allowing your body to repair itself to the degree it can, however, you are going to have to do two things: Stop making excuses and stop looking for answers in a damned pill bottle -- or a surgeons office.
The answer is found in what, not how much, is in your pantry and refrigerator.
Go through your house -- pantry, fridge and freezer. Throw anything on the "don't eat list" in the trash can and never let it come back into your home or pass your lips when you are somewhere other than at home.
Go to the store once you've thrown everything away on the "don't eat list" and re-stock your fridge with things on the DO eat list. Note that almost none of them will go in the pantry because the pantry is for things that are shelf-stable and processed. A few will go on the counter that are going to get eaten within a couple of days but the rest go in either the fridge or freezer.
Don't tell me that you can't do it because you can do it. You can do it when you're home and you can do it when you're eating away from home. If you absolutely must have a sub sandwich when out go to Jimmy Johns and have them make it as a wrap; they will, in lettuce -- or if you want then go to Subway and have them make your "sub" as a salad (same thing but with the lettuce chopped up and thus less-convenient to eat "on the go.")
If you're overweight your pants will shortly try to fall off, but more-importantly your body knows how to regulate its caloric intake if you stop poisoning the mechanisms that control it. When you reach an appropriate weight - which is not one where you're "large", but rather a body mass that looks like a normal, not-fat person in every case (no, you're not "special" in that regard: You're not "big-boned", you're fat) the weight loss will stop all on its own without you making a conscious decision to do so.
Here's the thing, however: You can't get there from here if you "diet" because as soon as you stop "dieting" you will go back to poisoning your body's metabolic signalling system and the weight will come right back on. In fact it may come back on faster than ever because some of the damage you've accumulated is probably permanent.
This is not a matter of "blame" it is a matter of fact -- whether you undertook what you did because you were stupid, you got bad advice from so-called "professionals" or any other cause doesn't matter.
You are an adult and thus you are responsible for the outcomes that occur when you listen to various people no matter who they are.
If you take someone's advice and it doesn't work but you keep doing what you were told would work why in the hell would you keep listening to them?
Look folks, do it for 30 days. That's all. I'm no doctor but I can tell you what works because it did after a couple of decades of the "conventional advice" not working. I can also point you to the comments here from others who also had it work with some of them having ridiculously dramatic results when it came not so much as to weight (in that short amount of time) but metabolic markers of serious disease such as their blood sugar. This isn't something that was a "fad" or an undertaking that I "recently" did and thus can't give you any sort of honest answer on whether the weight I lost will stay off.
You want to know how many people I've run into who have actually done this and not had it work? Zero. Every one of the people I've been acquainted with that failed has admitted they just didn't do it. They ate the pasta. Or the potatoes. They called Dominos and ate the pizza. Or they just "had to have" the pie. Or sugar in their coffee. They had the craving, they had a bad day exercising and had to "add back" some carbs (even though they were less than a week into it), and on and on. Rather than tough it out for a few days, literally, knowing it would go away in a few days to a couple of weeks (like a cold does) if they just kept at it, they didn't.
It didn't fail -- they simply didn't do it and they admit it.
I changed my lifestyle in this fashion in 2011. I used no drugs, no doctors and no surgical interventions -- nothing other than what I stuffed in my pie hole and had in my house. I did it despite having a kid at home at the time who refused to give up her Doritos, M&Ms and similar.
Despite the bad stuff being present I didn't eat them, choosing instead to reach for the broccoli or piece of leftover zero-carb roast.
If you're one of the millions of Americans who have heard that it's all "hormonal", that you need "help", that you have a "damaged" metabolism and "it's not your fault" or that nothing other than invasive surgery or drugs (and perhaps not even then) will make a long-term difference what do you have to lose by trying?
Do you really think that a month or two of changing what you eat is going to do some critical damage that all those years of piling on the pounds hasn't? Are you really too lazy to go spend under $50 for instrumentation that will (largely) last virtually forever to test a hypothesis on your body and your metabolism and give you objective results by which to measure whether it works or doesn't? I don't think there's anywhere in this country that's more than a 20 minute drive from a WalMart these days and if there is Amazon covers every US address within a couple of days (even without Prime) so there's simply no excuse other than willful refusal.
You can't argue with objective numbers so if you don't have them because you won't go buy the $20 worth of stuff to obtain them in the privacy of your own home where nobody else can ever see them then the only excuse is that you are consciously refusing to put such a change in eating habits to an objective, personal test.
If you're happy with being overweight or obese, or worse you expect someone else to either fix it or give you a pill then shut your pie hole and deal with the consequences of your choice. A choice that, I remind you, given our corrupt and extortionate medical system will bankrupt you as well as having a high probability of making you both sick and ultimately dead.
Or, for nearly zero money you can change, what, not how you eat -- not as a "diet" but as a lifestyle and as a side effect it is highly like that your pants will fall off.
The medical industry doesn't want you to read this.
Nor does the food industry.
But you should read it, and let it sink in.
There is a lot of BeeEss flying around about low-carb eating. Here are some common myths and truths related to this lifestyle.
Once again, for those who missed it the last time, here's the "don't eat" list:
So what do you eat?
If you eat this way it is very hard to exceed 50g/carb a day. As an example a cup of brussels sprouts has eight grams of carbs, only five of which count (3 are fiber and don't digest.) If you eat a cup of those, two cups of broccoli flowers during the day in various snacks (8g more), one cup of green sweet pepper chopped up as a component of a main course or side for dinner (4g net) you'll have eaten quite a decent amount of vegetables yet you only consumed 17g of carbs net all day; you'd also have consumed just 108 calories. You could triple that and still be ok on the carbs and yet have consumed just about 1/6th of your caloric intake requirement!
It then becomes a matter of choosing protein sources without trying to limit fats and, in fact, buying the cheaper sources tends to work better because the stores charge more to trim or otherwise remove the fats! Between eggs, cheeses and animal products while intentionally leaving the fat content present you'll wind up with a low-carb diet that is very rich in nutrients and almost-completely absent in insulin-spiking carbs that also happens to be free of PUFAs that are associated with heart disease.
Oh, and you won't be hungry either; your body knows how to regulate its food intake all on its own if you simply stop poisoning the signalling pathways (largely mediated by leptin) that tell you whether you're hungry or not.
Welcome to waking up and not really wanting anything to eat until the middle of the day; a nice side effect of living this way is that your pants will fall off.
The so-called "authorities" on health all admit that half of all adults are metabolically compromised (in terms of insulin resistance) with most of those over 65 being in this situation.
Being metabolically compromised places you at a materially higher risk of diabetes and heart disease. These are diseases that may kill you, but even if they don't they are debilitating. Obesity is a big part of that; you can't run, you can't move, you wind up with joint replacement surgery as you age (which has to be re-done every 10 or 20 years and is major surgery) and, if it gets out of control it can and will lead to amputations, blindness and ultimately kidney disease and dialysis.
This is a miserable way to live the last 20, 30 or 40 years of your life and it's not a pleasant way to die either.
Most people will say "well, I have no symptoms and my doctor is ok with what I'm doing", so they'll ignore the possibilities here. This is extraordinarily unwise as the damage that causes these diseases happens over years or even decades before clinical disease (that sends you to the doctor) presents itself.
It is easy and inexpensive, however, to know if that damage has accrued to the point that some detectable signs are present. You can do it at home, and you should because once these markers get into your medical chart they never go away and while people may think they're protected by Obamacare right now until and unless we deal with the medical monopoly situation in this nation you are risking financial ruin without cause if those markers get into your chart even if you reverse the damage.
What happened before Obamacare and will happen if and when it collapses? If those markers are in your chart you may become completely uninsurable at any rational cost. That means that any major medical emergency instantly bankrupts nearly anyone.
As an aside I'm going to make an assumption here: You're not diabetic today (diagnosed.) If you are diabetic then none of the below is news to you in terms of testing as you already have these results over time since they're part of what your doctor has you doing already. Nonetheless, you might be shocked at the improvement from the below eating pattern changes, so keep reading -- just ignore the testing thing, as you're already doing it.
This is something you can do in the privacy of your own home with nobody but you having the results. You can then change your behavior, specifically, what you do and do not eat, if you have a deteriorating situation and see if it improves. There is little cost to this, essentially zero risk over the time involved and if it doesn't work for you or if you think I'm a crackpot (I don't have an "MD" after my name, after all) you will have lost nothing other than a few dollars that were spent on something you probably ought to own anyway, one of which is not consumed.
You're going to go buy two things:
1. An A1c test kit. WalMart has them and they're under $30. There are two tests in the box, so each is about $15. No, one isn't for your SO, spouse or kid -- they're both for you. If you have two people to check buy two. These are consumed and tossed when used up.
2. An inexpensive glucose meter and a box of lancets. Buy one of the models with inexpensive strips; the meters are all cheap (~$20 or so) but the strip cost varies widely, by as much as 500%! While you're not using this for diabetes monitoring this is a device that will last years if not a decade or more so strip cost does matter, although not nearly as much. Again, WalMart has a wide selection -- IMHO make yours based on the strip cost (lower is better) and choose one that has individually-wrapped strips (this way they do not deteriorate by having a bulk package opened, since you are not using these multiple times a day as a diabetic would.)
When you get home open up the A1c kit, read the instructions (yes, you have to follow them to the letter to get good results) and run one. Keep the second. Write down the result.
The ADA and "some" docs say any A1c number under 6.0 is ok. You want a number at or under 5.6%. Note that these kits as with all tests, including lab tests, have an error band to them which means that one test provides decent information but you need to check it as the actual number could be a few tenths to either side of the displayed result. Don't use the second test immediately (unless the first errors out due to a mistake on your part); you'll use that a month or two down the road to both check the error band (the odds of a random error going the same way twice is 1 in 4 instead of 1 in 2) and your outcome.
Be aware that there are some confounding factors with the A1c test. First, it "assumes" blood cells live three months. We know this is not always true; people with severe metabolic damage tend to have them live for less (which means the number reads low) and those without said damage tend to have them live longer (which means the number reads high) since what A1c measures is the percentage of glycated hemoglobin in the blood. Further, if you have some conditions, among them anemia (in particular) it will read low because in that case hemoglobin is below normal levels -- this is a particular risk for women who don't get enough iron in their diet although there are other causes. This probably won't change your test result enough to matter, but it is the reason that standing alone an A1c test, while good and in fact an essential checkpoint, isn't enough.
Next, you're going to do two different checks with the glucose meter. The first is a fasting test, which is done when you first wake up in the morning before eating or drinking anything other than water. Most meters will store some amount of history but again, write it down. If your number is under 90 but greater than 50 that's ok. If it's under 50 test it again -- a persistent result under 50 is an indication of hypoglycemia (low sugar) which is dangerous as levels below 40 can cause you to pass out (and if nobody finds you and deals with it you can die), so if you get a confirmed reading under 50 consider obtaining medical advice. Again, the ADA and some docs say anything under 100 is ok. Correct clinically but wrong for the purpose you're intending here. If you get a number over 90 do it again the next day; if you get a second reading over 90 you've got a potential problem.
The final thing you're going to do is wait until you eat a "normal" meal at home (whatever that is) but it should include a decent amount of carbohydrate. "Decent" doesn't mean carb overload, but it does mean roughly the equivalent of one cup (cooked) of rice. If you eat low-carb normally, this is your chance to eat something you usually don't. Test your blood sugar level before eating, then test again both one and two hours after eating. Write down the results; no relying on memory here. You should not get a result over 140 on either of the post-eating tests and ideally within two hours you should be back to where you were before consuming the meal. If you're not, take a third test at the three-hour point.
Now let's interpret.
If you are eating food containing carbs on a regular basis, your A1c is at or under 5.6 and your fasting glucose is under 90, neither of the one and two-hour post-meal readings exceed 140 and you are back to baseline within three hours you are probably ok metabolically at this point. This doesn't mean you don't have insulin resistance of some amount but at this point it is not manifesting in clinically-detectable harm to your cardiovascular system. If you are eating low-carb and have been for several months or longer your fasting glucose level may be a few points higher, anything under 100, and is ok provided the other two tests are both in-range. Note that if you are overweight you probably are metabolically compromised (an OGTT w/insulin assay would easily detect it) but the test is expensive and frankly, the mirror works just as well for anyone in this category: If you have a gut, you're metabolically compromised. Incidentally just because you eat low-carb you are not necessarily going to get a somewhat-higher fasting glucose level; I don't, for example, and I've been eating low-carb now for something like five years now but some people do. If you are eating low-carb and get a reading over 90 for your fasting glucose there is a decent chance you're doing it wrong; specifically, you may be eating far too few green vegetables in an attempt to go "very low or zero carb" and thus massively short on vitamin and mineral nutrients. It is possible to eat "VLC" and not have this problem but severe nutrient deficiencies play hell with hormone levels, so don't just blindly accept that an elevated fasting level is "ok" -- it's not, and it usually means you're doing something wrong and accumulating damage.
If your A1c is over 5.6 (but under 6.0) or your fasting glucose is over 90 (over 100 for low-carb eaters) or your first two-hour post-meal readings (either or both of them) go over 140 or you are not back to baseline within 3 hours you are accumulating metabolic damage that is doing material harm to your body. Your doctor will probably not detect this in his routine screen but if you ran the (expensive) OGTT w/insulin assay test, which your insurance will not cover in this instance since there is no clinical indication of disease, I'll lay a large wager it would show significant metabolic compromise with insulin levels perhaps as much as twice normal levels. You're at severe risk down the road even if you are not overweight and if you are overweight you're a walking heart attack or stroke unless you change what you're doing. More than half of all adults in the US and most people over 65 are in this category or one of the worse ones below.
If your A1c is over 6% or fasting glucose is over 100 (irrespective of what you eat) or either of the first two post-meal readings is over 160 (you almost-certainly won't be back to baseline within 3 hours in this instance) you're either diabetic now or shortly will be. Your doctor will be able to detect this in a routine screen; if he's honest he'll call it "pre-diabetes" and if he does your medical chart will be "branded" forever which, to the extent legal now or ever again, will trash your ability to obtain health insurance at a rational cost. You'll also get a whole raft of pills shoved at you, probably including metformin (to start) and a statin. That's the traditional thing for them to do but it may be both harmful and unnecessary.
If your A1c is over 6.5% or fasting glucose is over 130 or any of your post-meal readings are over 200 you are in trouble as you are almost-certainly clinically diabetic now. This pretty-much meets the "bright line" test in the medical establishment to call you diabetic. If this is the case your chart and impact on health insurance is irrelevant if you change nothing as it is a virtual certainty you will if not are suffering real, material and serious damage to your health. You're probably symptomatic too but denying it. It is your call what to do with that information but before you run to the doctor for a formal diagnosis and permanent branding on your medical chart, assuming you haven't previously been diagnosed, read the rest of this article.
If you're of both of normal weight and your results are in the first category then relax -- and in a year, or if you become overweight, do it again just to keep tabs on things.
But let's assume you are either (1) overweight or (2) your results are in any of the bottom three categories irrespective of your weight.
Try the following for a short period of time (4 weeks):
1. Stop eating sugars of any sort. If it says "sugar", "fructose", "sucrose", "corn syrup", "hfcs" or anything of the sort anywhere on the label do not eat it. No more cookies, no more chocolate, no more sugar in the coffee, no sugared sodas, etc. Just stop. No exceptions, no tapering down, stop.
2. Stop eating starches and grains. No more pastas or potatoes of any sort. No more bread irrespective of the type.
3. Stop eating anything containing machine-processed vegetable oils. No more corn oil, canola, rapeseed, etc. No cooking with any of these oils and yes, that includes peanut oil; the only exception is olive oil as a salad dressing (e.g. with vinegar.) This crap is in a lot of "food" and no amount of it is healthy. This means no more packaged foods in the general sense; no more boxed dinners, canned ravioli, "lunch pouches or easy-prepare things" and similar (those probably break all three constraints!), nothing that comes in a bag (other than frozen vegetables), etc. This also means no fried food of any sort prepared away from home since essentially nowhere fries anything in either tallow or lard any more (but they should.) If you like wings find a place that bakes them and order them with the dry rub instead of the HFCS-laden sauce.
These three rules above are absolutes. You'll be tempted to cheat, but we're talking about a month here. Just don't; you can do it, and you know it.
Now on to what you do eat.
4. Do eat all the green vegetables, whole, not canned or packaged, you want. Find something or a bunch of somethings you like such as broccoli, brussels sprouts, bell peppers, lettuce and similar. Whole, fresh or frozen (e.g. in a bag) are fine; canned or otherwise processed are not. Substitute these any time you would otherwise eat any sort of snack and keep eating them until you're not hungry any more. It's not impossible and it won't hurt you; in fact, they're all good for you. It is close to impossible to overeat if you're consuming green vegetables.
5. Do eat full-fat protein. Pork, chicken (skin-on, not trimmed), steak, hamburger (no bun; that's grains), fish, eggs, cheese, etc. No restrictions on any of these foods, but eat when hungry until you're not, not until "full."
6. Use spices, including pepper, cumin, etc. as much as you wish. Hot sauces typically contain zero sugar and are perfectly fine even in wild amounts (yes, Tobasco is ok.) This is a taste-based thing, of course, but anyone who thinks you can't toss on the Lowrey's or pepper the hell out of your steak is flat-out wrong. Not only can you use salt unless you are one of a very small percentage of the population that has a genetic intolerance to sodium restricting salt intake is worse than worthless in that electrolyte imbalances lead to cramps (especially if you exercise) and can be dangerous.
7. Be careful with legumes and nuts. These are generally ok but nuts are very high in caloric content and it's easy to wind up eating 3,000 calories worth of them in a few minutes! So if you want a few as a snack, go ahead; just don't eat them as a meal rather than as a snack. But do not generalize this to nut-based oils (such as peanut oil) or anything processed from nuts because you are then concentrating the bad without the balance of the good (see above in point #3.)
8. If you normally consume alcoholic beverages keep it to one per day on average and not more than two on any day.
9. Drink any time you're thirsty; water is of course ok, if you like coffee go right ahead. Cream is ok (not non-dairy creamer, actual cream that has to be in the fridge) but sugar is not. If you want sweetener use any of the non-sugar ones (we're not going to be a nazi about these for this purpose.) Diet sodas may be ok, but if you can avoid them do so.
Do this for one full month.
Now repeat the above tests. Note that A1c typically measures average blood glucose levels over about a three month time frame, so the change there may not be dramatic and in addition the error rate on the test may obscure the results.
But remember the above table; if you drop a category or approach doing so you have hard proof that you required no medication whatsoever to improve your situation and these results are individual to you.
In other words you didn't read something on The Internet by some kook (like me), you didn't take blind advice from some doctor or nutritionist (irrespective of how many letters are after his name) you ran an individualized test with objective results on your particular genetic and metabolic make-up and have a set of numbers before you that document the outcome in your particular body.
If the results show no change (or get worse) then you've lost nothing other than a bit of time and a few dollars. Over this short of a period of time no harm is going to come to you; the harm that comes from bad metabolic markers in this regard requires years of accumulation before it "gets" you. But if the results are either dramatic or trend the right direction (and if you actually do the above it's a good bet they will) you now know that it is possible to change those objective metabolic markers through near zero-cost measures that are easily implemented in your daily life without spending one minute in a doctor's office or taking (and spending money on) one single pill.
Is that enough motivation to continue for another month or two and see if you can return your metabolic profile to the top, that is, "ok" category?
Further, you just prevented yourself from being "branded" in your medical chart and you didn't do it by cheating, you improved your actual metabolic profile.
That ought to be plenty of reason to continue on that path and make it a lifestyle, considering that the difference between said improvement to the top category and any of the others is a very material change in your risk of heart attack, stroke, blindness, amputation, dialysis and death! Further there's a very good chance that at the same time you're going to see a change on the scale if you're overweight, and I bet you'll like that change as well.
In 1940, entitlement payments, which include everything from disability payments to Social Security to Medicare, amounted to just over 20% of annual government spending in the United States.
Today, entitlement spending has swelled to nearly 70% of the annual federal budget.
Things are about to get a whole lot more complicated. The 20-year baby boom that took place after World War II is now beginning to result in a retiree boom.
For context, Druckenmiller points out that in 2030, the average age of an American citizen will be older than the average age of a resident of Florida today.
This demographic trend is going to create an entitlement spending catastrophe.
It doesn't have to, and the root of it isn't "entitlement spending", in the main.
Let's think this one through.
Social Security is funded by a "one in 8" tax, basically. That is, about one dollar of every $8 you earn up to a given cap is confiscated before you ever see it. You think it's half that, but it's not because the other half is paid "by your employer" and this fiction is maintained so you don't revolt.
However, your offered wage is reduced by that amount -- guaranteed.
So let's assume that we have a 2.5:1 ratio as is put forward. That sounds horrifying, except that it's a temporary problem (it lasts 20 years, roughly), and then everyone involved in "causing" it is dead. Further, there will be some that will "file late" for Social Security in an attempt to get more -- a strategy that only works if you live a very long time in terms of total funds, and lose their bet because they will die before the break-even is reached. In fact, actuaries don't care if you make this bet because they know that on balance while some will win, some will also lose and it will all even out.
No, the problem here is not the "one in 7.5" tax for Social Security. It is the one in 34 rate assessed for Medicare.
To put not too fine a point on it, Medicare and Medicaid (combined) are roughly double the outlay of Social Security and yet they are funded at a rate of less than 1/4 that of Social Security via taxation.
Further, Social Security outlays are indexed to alleged inflation, which is intentionally machined to show smaller than real figures, and thus there is a built in depression of Social Security obligations in real terms, especially over long (20, 30, 40+ year) timeframes.
Social Security itself is unlikely to go broke. If it does "run out of money" 30 years hence there will be some reduction in benefits, but remember that even a 1% inflation "miss" against reality over 30 years turns into a 35% reduction in real expense. In other words the "you'll only get 70% of your promised amounts" out of Social Security claims are probably dead wrong; you'll get the entire amount but it will be short in purchasing power by 30%.
The disability fund is another matter; that's bankrupt now and politicians have been stealing from the retirement fund for a while to cover it up.
On the other hand Medicare and Medicaid spending is going up at a radical rate compared to inflation, government-stated or not. How bad is this?
Fiscal Year 2005, for example, spent a total of $652 billion.
Fiscal Year 2015 spent a total of $1,297 billion, or close to a clean double in 10 years.
This was not mostly-centered in Medicare -- that is, retirees. Medicaid went from $182 billion to $349 billion, damn close to a double standing alone. In other words it was across-the-board in all age groups served.
That's a 7.2% growth rate which far exceeds alleged inflation -- inflation allegedly was up 20% over the same 10 years, or an annual rate of about 1.8%.
In other words that segment of the economy as spent by the government went up at a rate four times that of general prices.
Need I remind you what happens any time two exponential growth curves have a different growth rate? Go look at Leverage; there's a damn good reason that this is covered in the front of the book because if you don't understand and deal with it nothing else matters.
This, and only this, is the cause of all of the federal debt expansion, pension fund problems both private and public and the detonation that will occur in the federal budget and forward liabilities unless it is stopped and reversed.
Note carefully that we spend as a nation roughly double as a percentage of GDP what other developed, G20 nations spend on health care -- and virtually all of those other nations have socialized medical systems.
Socialism is always less-efficient than capitalism because there is no reward for innovation in a socialist system; you cannot take market share from someone else since market share is not a function of market success or failure.
This, in turn, means we're definitely overpaying by more than twice for medical care; we are in fact probably overpaying by as much as 80% across-the-board.
It is not hard at all to find examples of people being billed 10 or even 100x a price in another nation for a given thing. It is cheaper for me to fly to Narita, Japan, round-trip, and have an MRI done there by more than 50% than the average amount charged for the same scan here in the United States.
While you can in some cases get that scan done for a few hundred bucks here they're all $200 or so in Japan, and most people grossly overpay here in the US. Why? Because of various practices that all amount to consumer deception, extortion, price-fixing or all of the above -- all acts that are supposed to be crimes.
Let's say you go to the ER "in-network" on your alleged health insurance. While there some doctor sees you. He isn't in your network and you get a bill for hundreds or thousands from him. The hospital administrator should be imprisoned for allowing this along with the doctor who did it; you neither consented to such a bill nor in many cases had any ability to refuse, but the administrator could have required that said doctor be "in network" to be there or if not that he take the same reimbursement rate as if he was. He didn't and thus they both took advantage of your "in extremis" situation to bilk you. That's supposed to be illegal as a matter of general consumer protection yet not one person has gone to prison for it -- ever -- that I can find a record of.
Drug companies set prices by nation based on various things, including GDP and what they think their drug is "worth" in terms of your life or health. It's illegal to restrain trade (15 USC, Sherman, Clayton and Robinson-Patman) yet that's exactly what they do, with the help of the Federal Government, in that if you get on a plane and buy a suitcase full of some drug at a much cheaper price to try to bring it back and both make a profit while dropping the cost here in the United States it is you rather than they who will go to prison.
It is virtually impossible to get a binding quote on a procedure from nearly all medical facilities in advance. The notable exception are places like The Surgery Center of Oklahoma, which posts "all-in" prices. I note that said prices are typically one third to one fifth of what is charged in hospitals that don't post prices, including hospitals in the same general area of the country. Gee, I wonder why, and then one wonders why there haven't been thousands of criminal indictments and lawsuits alleging racketeering and extortion filed against the administrators and doctors in all the other hospitals.
Here's the reality folks, and it's a matter of arithmetic, not politics:
If we stop this right now the Federal Government would immediately and permanently run a roughly $400 billion a year surplus. In other words your purchasing power would go up rather than down every year and the federal debt would slowly be retired at a rate of about a trillion dollars every three years.
In addition the "entitlement bomb" being discussed in the linked article would instantly and permanently disappear. It simply would not exist; the short-term stress on Social Security would be manageable without material changes to the program due to the inherent understatement of inflation in the CPI used to link benefits and over the longer, indefinite time horizon the program remains stable.
Finally, were we to stop this keeping the Medicare impact on Seniors as it is today would allow Medicare to almost entirely disappear. The reason is that Medicare is an 80/20 program; if the base cost of medical care decreases by 80% (and if we only equal the socialist nations it would fall by 50%; we can do better than that with capitalism) then exactly zero needs to be spent for the cost to an actual Senior to remain the same. However, since we did promise such an 80/20 program keeping that promise is not an irrational act and thus some spending (about 1/8th to 1/5th of what it is now) would remain. Likewise, Medicaid is currently basically-zero cost for beneficiaries; if the cost of care drops by the expected amount we might well be able to get rid of many of the beneficiaries entirely since they would be able to afford to pay cash.
FISCALLY SPEAKING THE ENTIRE PROBLEM RESTS HERE -- AND NOWHERE ELSE. IF WE FIX THIS WE NOT ONLY ARE OK AS A NATION FROM A FISCAL PERSPECTIVE WE PROSPER. IF WE DO NOT FIX THIS AS A NATION WE FISCALLY (AND PROBABLY POLITICALLY) DIE.
THIS IS NOT POLITICS, IT IS ARITHMETIC. ARGUING OVER OTHER MATTERS WHEN IT COMES TO OUR POLITICAL SYSTEM, UNTIL THIS IS ADDRESSED, IS STUPID AND SERVES ONLY TO PROTECT THOSE WHO ARE CURRENTLY ROBBING YOU BLIND -- LITERALLY.
INSTEAD WE SHOULD BE DRAWING UP LISTS OF PEOPLE AND FIRMS TO BE INDICTED AND IMPRISONED. AFTER JUST THE FIRST FEW WERE SERVED THIS ENTIRE EDIFICE OF FRAUD WOULD COLLAPSE IN UPON ITSELF AND PRICES WOULD FALL LIKE A STONE.
WE EITHER DEMAND AND ENFORCE THIS NOW OR NOTHING ELSE MATTERS.
Let's update one of my Tickers from a few years ago.
We're going to use official government figures here, ignoring, for now, the private sector.
The figures of note are the following (figures to the nearest billion), out of a total of $3,688 billion.
Military programs: $563 billion or 15%
Social Security Old Age: $741 billion or 20%
Social Security Disability: $146 billion or 4%
Medicare and Medicaid: $1,297 billion or 35% (Medicaid amounts to $350 billion granted to the States (no breakdown on what part is drugs), Medicare Part D (drugs) is $75 billion; the rest is clinical services for the most part -- hospitals, doctors and similar. S-CHIP, the children's portion, is $9 billion (insignificant) and administrative expenses are about $14 billion total, which is damned efficient -- only 0.4%. Incidentally I don't believe that figure, but even if it's three times as much it's still damned impressive.)
VA (Veterans Health) approximately $61 billion or 1.7%
SNAP - food stamps -- is $104 billion and is up from last year, despite so-called "improvements" in the job market. TANF is a separate line item, $16 billion. Together, 3.3%.
That's where the money goes. Conflating Social Security and Medicare/Medicaid is the common horsecrap line run by both parties, but it's intentionally dishonest. Disability is a fraud-riddled mess, but the "old age" part of Social Security is neither going to bankrupt the nation nor is it an immediate budgetary problem.
But the $1,297 billion in Medicare and Medicaid is.
Now let's look at what Trump is proposing against this.
Price transparency in the pharmaceutical area alone would be a monster. Let's assume that of the $350 in Medicaid 10% is drugs. That makes drugs a roughly $110 billion annual federal expense.
What happens if you ban the gouging that is done today across the entire medical industry?
Well, let's remember that Medicare is an 80/20 program. That is, the government pays 80%, you pay 20%. If you look at the cost of procedures at the Surgery Center of Oklahoma, which I have posted multiple times, you'll find that many of them are about 1/3rd to 1/5th the price of local hospitals.
In other words a very material percentage -- perhaps as much as 80% -- of Medicare's non-drug spending would disappear and your bill as a Senior would drop by the same amount.
That is, of the $872 billion spent now on non-drug services on Medicare, not Medicaid, and we manage only to cut the cost in half, which just takes us to where socialized medicine manages to get in other G8 nations, $436 billion of spending by the Federal Government would disappear each and every year.
In reality competitive markets outperform socialized ones in virtually every case where there are multiple and diverse providers of products and services. As a result that 50% decrease is ridiculously conservative; I expect we'd achieve 70%, leaving us with just over $600 billion less in Federal spending every year.
Now take the drug side, which is $110 billion and presume that by leveling prices on an international basis (by ripping down the barriers) we also get a 50% savings there. That's another $50 billion every year and again, that is probably conservative; the actual drop would likely be higher.
Now let's turn to Medicaid. If we save half under the same approach, and do not drop any of the poor from the rolls (which we should be able to do for the same reason; some currently on Medicaid with this very large drop in price would be able to pay cash) we'd save another $157 billion.
We just generated $800 billion, or $8 trillion over the usual "10 year" period that is quoted, in spending cuts and not one person had one benefit they currently enjoy from the Federal Government touched in real terms.
What's even better is that we did it in one literal day starting on the first day rather than some mythical Unicorn-style belief of savings a decade hence (that have never materialized, incidentally) that the GOP typically puts out in their "budget projections."
It gets better. The Federal Government, as noted, spent $1,300 billion last year on medical care (ex the VA.) The economy as a whole spent about $3,420 billion; the other $2,100 billion or so was spent by the private sector.
These same ratios would apply to the private sector and thus you, as a consumer, would see an approximate 10% immediate and permanent increase in your real purchasing power because you would no longer be spending it on health care, either through "insurance" or directly. If your "health insurance" is through your job you'd get that 10% in the form of a raise as the cost of said insurance to your employer would drop precipitously.
Even better, the benefit would skew wildly toward those in the lower income but insured income brackets (e.g. full-time middle-class workers) because the percentage of your pay that goes to health insurance is much higher than it is for someone who is making $300,000 a year.
Of course the medical, pharmaceutical and insurance industries will scream. But there's really nothing to scream about; the claim of "charity care" is nonsense in a world where Obamacare and expanded Medicaid exists; you either have one or the other, right? As for pharmaceutical companies if they charge $2,000 everywhere for Sovaldi or $1,000 in Pakistan and $80,000 here in the United States they make the same money; what they can't do any more, nor can other nations, is soak the United States, effectively forcing our citizens to fund 100% of the development costs for drugs they then get to use.
If you're middle class these changes would mean you would be able to pay cash for anything routine and normal, and catastrophic insurance against the unthinkable (e.g. cancer, etc) will now cost a tiny fraction, 10-20%, of what it does now. That in turn means you can afford to buy it on the open (cross-state, in Trump's case) market so if Obamacare is repealed even the modest-income household can pay for said catastrophic coverage and cover the rest in cash.
Even having done so you will still be ahead on purchasing power by about 10% if you're in the middle class and quite-possibly materially more if you're in the lower income brackets and have a chronic illness. If you're wealthy you'll see a benefit too, but on a percentage basis it will be quite a bit less.
And that's just the direct impact on your personal budget that you will see immediately.
The real benefit is the long-term macro-economic benefit that comes from getting rid of federal deficit spending on an immediate and permanent basis.
Because the United States will now be running a roughly $350 billion a year surplus instead of a deficit we will start to retire the national debt. Yes, it will take decades; four or five to be exact. But that $350 billion in debt reduction every year means your purchasing power goes up even more; that is, there are fewer dollars in circulation and so each is worth more in goods and services.
This is the invisible benefit but it will accrue to everyone in the United States equally. Rich, poor, white, black, yellow, green, young, old, doesn't matter -- everyone will see an exactly identical percentage benefit.
How much? About 2% a year, every year, until the debt is retired.
That's right -- instead of you suffering inflation of the mythical 2% a year and your purchasing power being destroyed you will instead be able to save for retirement and see a 2% compounded improvement in what that money buys without taking any risk in the stock market or even being paid interest at the bank!
Finally, at the same time all of these really good things happen to you personally and the federal budget, state and local budgets, which are under severe pressure due to these spiraling costs embedded in their pension expenses, will all be immediately and permanently returned to a stable state as well.
Now this is, admittedly, assuming that Trump is actually able to implement his proposal and you can bet that there will be a lot of corporations and pressure groups that are going to do everything they can to derail it, especially when it comes to anything that has to pass through Congress.
But I will remind you that while the Executive (which is the part of the government the President controls) cannot make laws it is the Executive's job to enforce laws and there is a large body of law, specifically 15 USC, that makes felonious any attempt to monopolize a market or fix prices.
The executive is empowered to enforce existing laws without any act of Congress whatsoever.
In fact, barring passing a new law there is absolutely nothing Congress -- or the lobbyists -- can do to stop him or any other President from doing so.
The reason none of the recent Presidents have done so ought to be obvious; they, along with Congress, have all been bought and paid for.